糖尿病影响心脏新证据!JACC重磅:控糖不佳或使心衰风险升高超6倍!

2022-08-12 代谢网 代谢网

总体而言,当前这项研究的分析结果证实,对于心衰前临床分期的老年人群而言,糖尿病控制不佳与心衰进展的风险显著升高有关。

近年来糖尿病已经成为威胁大众健康的主要疾病之一,糖尿病患者不仅需要长期接受治疗,同时还会引发多种并发症,心衰就是其中一种。统计数据显示,每3例心衰患者中就有1例患有糖尿病,糖尿病可使心衰的发病风险升高2至5倍。

目前心衰指南均强调关注心衰前临床(A期和B期)发展阶段的预防。但是截至目前为止,糖尿病对前临床心衰阶段进展为临床心衰阶段有何影响,科学家们仍知之甚少。近日,《美国心脏病学会杂志》(JACC)发表重磅研究成果,为我们提供了最新洞见!

研究分析结果指出,糖尿病(尤其是控制不佳的糖尿病)与心衰的进展强烈相关。与心衰分期为A期且不伴有糖尿病的受试者相比,B期且HbA1C≥7%的受试者心衰进展的风险可升高超过6倍!

截图来源:JACC

当前这项研究以社区动脉粥样硬化风险(ARIC)研究的第五次随访(2011-2013年)数据为基础,分析了糖尿病对心衰进展(前临床心衰发展为临床心衰)的影响。研究分析共纳入4774例前临床心衰(心衰分期为A期或B期,分别为1551例和3223例)的成人受试者。

受试者平均年龄为75.4岁,其中58%为女性,20%为黑人。随访8.6年期间,共有470例受试者出现心衰事件。分析结果显示:

  • 糖化血红蛋白(HbA1C)≥7%的B期受试者与糖尿病控制良好以及未罹患糖尿病的B期受试者相比,其进展为临床心衰的年龄更小(平均年龄分别为80岁、83岁和82岁;P<0.001)。

  • 与A期受试者相比(HR=1.52;95%CI:0.53-4.38),B期受试者HbA1C≥7%与心衰进展的相关性更强(HR=1.83;95%CI:1.33-2.51)。

  • 与心衰分期为A期且不伴有糖尿病的受试者相比,心衰分期为B期且HbA1C≥7%的受试者心衰进展的风险升高了6倍以上(HR=7.56;95%CI:4.68-12.20)。

▲是否伴有糖尿病对心衰前临床阶段患者疾病进展的影响(图片来源:参考资料[1])

总体而言,当前这项研究的分析结果证实,对于心衰前临床分期的老年人群而言,糖尿病控制不佳与心衰进展的风险显著升高有关。

论文同期评论强调,分析结果揭示长期发展或控制不佳的糖尿病或为加速心衰恶化(从前临床阶段向临床阶段转化)的关键危险因素。研究结果也提示,在糖尿病早期进行积极治疗对于预防心衰的发生和进展具有至关重要的意义。

参考资料

[1] Echouffo-Tcheugui, J. B., Ndumele, C. E., Zhang, S., Florido, R., Matsushita, K., Coresh, J., ... & Selvin, E. (2022). Diabetes and Progression of Heart Failure: The Atherosclerosis Risk In Communities (ARIC) Study. Journal of the American College of Cardiology, 79(23), 2285-2293.

[2] Verma, S., Pandey, A., & Bhatt, D. L. (2022). Forecasting Heart Failure Risk in Diabetes. Journal of the American College of Cardiology, 79(23), 2294-2297.

免责声明:药明康德内容团队专注介绍全球生物医药健康研究进展。本文仅作信息交流之目的,文中观点不代表药明康德立场,亦不代表药明康德支持或反对文中观点。本文也不是治疗方案推荐。如需获得治疗方案指导,请前往正规医院就诊。

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    2023-06-14 hbwxf
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    2022-08-06 xxxx1054

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